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Non-stroke Central Neurologic Manifestations in Antiphospholipid Syndrome
Abstract Thrombotic manifestations of antiphospholipid syndrome (APS) are well known, and various non-stroke neuro-psychiatric manifestations (NPMs) have also been consistently described, but their place in APS remains unclear. Some syndromes, such as migraine or cognitive dysfunction, are frequently described in APS, whereas others, like seizure, multiple sclerosis-like symptoms, transverse myelitis, movement disorders, or psychiatric symptoms, are rarely found. Overlap with other autoimmune diseases, in particular with systemic lupus erythematosus, the lack of large sample size prospective studies, and discrepa...
Source: Current Rheumatology Reports - February 29, 2016 Category: Rheumatology Source Type: research

Using New Oral Anticoagulants in Patients Undergoing Major Orthopedic Surgery
Abstract Four new oral anticoagulants (NOAC), apixaban, rivaroxaban, edoxaban, and dabigatran, are now available in the USA; however, only apixaban and rivaroxaban are FDA approved for the prevention of venous thromboembolism following orthopedic surgery. Apixaban, rivaroxaban, and edoxaban’s anticoagulant activity can be measured using a chromogenic anti-factor Xa assay but there is no widely available means of measuring dabigatran blood levels. None of the NOAC has an antidote. Dabigatran is 80 % renally excreted, and patients with atrial fibrillation taking dabigatran for stroke prevention should stop the d...
Source: Current Rheumatology Reports - April 8, 2015 Category: Rheumatology Source Type: research

Prevention of Recurrent Thrombosis in Antiphospholipid Syndrome: Different from the General Population?
Abstract Antiphospholipid syndrome (APS) is characterized by arterial and/or venous thrombosis with or without pregnancy morbidity in the presence of autoantibodies targeting proteins that associate with membrane phospholipids, termed “antiphospholipid antibodies” (aPL). Management of arterial and venous thromboses shares some similarities with management of arterial and venous thromboses in the general population; however, there are key differences. The majority of studies addressing management of thrombotic APS focus on secondary prevention. Vitamin K antagonists (VKA) are typically used for secondary preve...
Source: Current Rheumatology Reports - March 30, 2016 Category: Rheumatology Source Type: research

Deficiency of Adenosine Deaminase 2 (DADA2), an Inherited Cause of Polyarteritis Nodosa and a Mimic of Other Systemic Rheumatologic Disorders
AbstractPurpose of ReviewA new autoinflammatory disease, deficiency of adenosine deaminase 2 (DADA2), caused by mutations in theCECR1 gene, was first reported in 2014. This review aims to update progress in defining, treating, and understanding this multi-faceted disorder.Recent FindingsDADA2 was first described in patients with systemic inflammation, mild immune deficiency, and vasculopathy manifested as recurrent stroke or polyarteritis nodosa (PAN). More than 125 patients have now been reported, and the phenotype has expanded to include children and adults presenting primarily with pure red cell aplasia (PRCA), or with ...
Source: Current Rheumatology Reports - October 5, 2017 Category: Rheumatology Source Type: research

Is There a Brain/Heart Interaction in Rheumatoid Arthritis and Seronegative Spondyloartropathies? A Combined Brain/Heart Magnetic Resonance Imaging Reveals the Answer
AbstractPurpose of ReviewTo present the interaction between brain/heart and emphasize the role of combined brain/heart magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) and other seronegative spondyloarthropathies (SNA).Recent FindingsBoth traditional cardiovascular disease (CVD) risk factors and intrinsic RA/SNA features contribute to the increased CVD-related morbidity/mortality. CVD in RA usually occurs a decade earlier than age- and sex-matched controls, and RA patients are twice more likely to develop myocardial infarction irrespective of age, history of prior CVD, and traditional CVD risk fa...
Source: Current Rheumatology Reports - June 18, 2020 Category: Rheumatology Source Type: research

Hyperuricemia, Gout, and the Brain —an Update
AbstractPurpose of ReviewThis review aims to summarize recent evidence regarding the complex relationship between uric acid (UA), gout, and brain diseases.Recent FindingsObservational studies have suggested that patients with hyperuricemia or gout might have a decreased risk of neurodegenerative diseases. Conversely, they may be at increased risk of cerebrovascular disease. Mendelian randomization (MR) studies use a genetic score as an instrumental variable to address the causality of the association between a risk factor (here, UA or gout) and an outcome. So far, MR analyses do not support a causal relationship of UA or g...
Source: Current Rheumatology Reports - December 30, 2021 Category: Rheumatology Source Type: research